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The Sergeant and Suicide Prevention

Just returning back from North Carolina (Ft. Bragg)***, after spending a wonderful time with my daughter-in-law and grandson (3yrs) I was saddened (but not surprised) to learn of the difficulties and problems some of the soldiers experience while deployed. I can cite many articles about the deployment cycle and its’ affect on the military, it is worth mentioning however that difficulties such as depression, suicide, aggression (some of the symptoms of PTSD) aren’t necessarily exclusive to the ‘multi-deployed’, often, it can be ‘first time’ deployers. In fact, the military is studying the ‘mind set’ of the multi-deployed v. first or second timers to examine the element that helps them cope with extreme psychological pressures and extreme battle fatigue (both mental and physical).

Sleep in disorders of consciousness

Sleep in disorders of consciousness

Summary

From a behavioral as well as neurobiological point of view, sleep and consciousness are intimately connected. A better understanding of sleep cycles and sleep architecture of patients suffering from disorders of consciousness (DOC) might therefore improve the clinical care for these patients as well as our understanding of the neural correlations of consciousness.

Severity of head computed tomography scan findings fail to explain racial differences in mortality following child abuse

Severity of head computed tomography scan findings fail to explain racial differences in mortality following child abuse

Abstract

Introduction

Differences in head injury severity may not be fully appreciated in child abuse victims. The purpose of this study was to determine if differential findings on initial head computed tomography (CT) scan could explain observed differential outcome by race.

Methods

We identified 164 abuse patients from our trauma registry with an Injury Severity Score (ISS) ≥ 15. Their initial head CT scan was graded from 1 to 4 (normal to severe). Statistical analysis was performed to asses the correlation between race, head CT grade, Glascow Coma Scale (GCS) score, and mortality.

Results

• Overall mortality was 17%: 11% for white children, 32% for African-American children (P < .05).

• In review of the head CT scans there was no difference by race in types of injuries or head CT grade.

• Using a multivariate regression model, African-American race remained an independent risk factor for mortality with an odd ratio of 4.3 (95% confidence interval [CI] 1.6–11.5).

Conclusion

African-American children had a significantly higher mortality rate despite similar findings on initial head CT scans. Factors other than injury severity may explain these disparate outcomes.

AUTHORS:

Colin A. Martin, M.D.a, Marguerite Care, M.D.b, Erika L. Rangel, M.D., M.S.a, Rebeccah L. Brown, M.D.a, Victor F. Garcia, M.D.a, Richard A. Falcone Jr., M.D., M.P.H.

CITATION: Martin CA, Care M, Rangel EL, et al. Severity of head computed tomography scan findings fail to explain racial differences in mortality following child abuse. The American Journal of Surgery. 2010;199(2):210-215. Available at: http://www.ajsfulltextonline.com/article/S0002-9610(09)00249-9/ [Accessed February 10, 2010].

Standards of Medical Care in Diabetes—2010

http://bit.ly/9ZYhA2

Stress amplification effect of lung under blast load

Stress amplification effect of lung.

Under a blast or impact load, rapid movement of the thoracic wall generates stress in lung, a foam-like structure of high compressibility, which is different from general solids.

Due to this unique characteristic, it is hypothesized that when lung is subjected to a blast or impact load, there will be an initial low stress progressively developed into a high stress in a short duration in a thin layer of parenchyma at the lung surface.